Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multifl orum Thunb

• Published in: Gut and liver Vol. 5; no. 4; pp. 493 - 499
• Main Authors: Kyoung Ah Jung, Hyun Ju Min, Seung Suk Yoo, Hong Jun Kim, Su Nyoung Choi, Chang Yoon Ha, Hyun Jin Kim, Tae Hyo Kim, Woon Tae Jung, Ok Jae Lee, Jong Sil Lee, Sang Goon Shim
• Format: Journal Article
• Language: Korean
• Published: 대한소화기기능성질환·운동학회 30.12.2011
• Subjects: Drug induced Liver injury; Hepatotoxicity; Polygonum multifl orum Thunb
• ISSN: 1976-2283

Background/Aims: Complementary medicines, including herbal preparations and nutritional supplements, are widely used without prescriptions. As a result, there has been growing interest in the risk of hepatotoxicity with these agents. It is diffi cult to determine causal relationships between these herbal preparations and hepatotoxicity. We report on 25 patients diagnosed with toxic hepatitis following ingestion of Polygonum multiflorum Thunb. Methods: Twenty-five patients (median age, 48 years [24 to 65 years]; M:F=18:7) with suspected P. multiflorum Thunb-induced liver injury were admitted to our hospital between 2007 and 2009. We analyzed clinical and histological data, including the types and the duration of P. multifl orum Thunb intake and the duration of hospital care. We also determined the type of liver injury using the R ratio (serum activity of ALT/serum activity of ALP). Results: The types of complementary medicine used included tea (n=16), liquor (n=5), tea and liquor (n=2), powder (n=1), and honeyed pudding (n=1). The most common presenting sign was jaundice (76%), and 18 patients (72%) had evidence of hepatocellular liver injury. Histological fi ndings were consistent with acute hepatitis in all cases (n=10) for which liver biopsy was performed. Twenty-three patients (91.6%) recovered with conservative management, 1 patient (4%) had a liver transplant, and 1 patient (4%) died of hepatic failure. Conclusions: In our cases, we found that P. multifl orum Thunb could be hepatotoxic and could lead to severe drug-induced liver injury, and even death. (Gut Liver 2011;5:493-499)